January 24, 2010

"If I won the lottery tomorrow, I'd pay for the operation straight away. But we don't have the money. People can have their own beliefs on whether they think this is a good use of NHS money but I just want what will make my child happy."

This is the case of a 16-year-old boy who "began researching sex change operations last year" after the kids at school "taunted him for being gay and... he was excluded from school after getting into fights."

"The psychologist said she was satisfied that Bradley knew his own mind and was eligible for a sex change and immediately put him on a waiting list for an operation."

What an insane way to solve problems! I suppose it's easier for the government to pay £10,000 for an operation than to deal with the harassment of a gay kid at school. The poor mother is eager to "make my child happy," but why would surgery be the first choice or even any kind of choice if the truth is that the child is gay and surrounded by people who don't know how to behave with any sort of decency?

Notice how this is a problem with the government running everything — not only the school, but also the medical treatments. When it's all a matter of economics, look at how evil it can get. It's easier to lop off body parts that to persuade groups of young people to treat each other kindly. There is one victim, and there are many harassers, so go after the victim, but call him "patient," and keep up the pretense of a caring, all-embracing government-parent... who only wants to make us children happy.

Another factor may be that he's 16. Under "death panels" you would expect the highest percentage of healthcare funds to be allocated towards young people, and most of the excesses to show up there as well.

It's the parents and the school district (and quite possibly the psychologist) that have the responsibility of dealing with any bullying of the kid.

If they, as you claim, are choosing to duck the issue with surgery, how is that the NHS or the national UK government failing to deal with bullying?

The NHS has a process and the kid and his shrink just followed it. That's not the NHS' fault.

The bullying forms only a small part of the article and it's definitely not clear at all in any way that the bullying is why this kid wants this operation. And presumably the psych has ensured its not.

I think you might consider if there's some amount of transphobia or ignorance on your part that makes you increase the role of bullying from how it was cited in the article.

I'm not sure I understand the thinking process going on here. How is a sex change operation a proper treatment for being gay? Most gays don't want to change their sex. If he's looking for protection from bullies he's not going to get it by going full tranny -- they have an even harder time in working-class Britain than gays do.

Be that as it may, sixteen is too young. Sixteen year olds don't have peace of mind about anything. He's not a woman -- he's not old enough, for one thing. At most, he's a girl. I'll bet you in a couple of years he'll be petitioning the NHS for reversal surgery to rebuild his dick -- and you know, he'll probably get it too. Whatever, cancer patients and people needing liver transplants are sickly and useless anyway; they don't even look good in an evening gown, what with the weight loss and the jaundice.

27183: The bullying forms only a small part of the article and it's definitely not clear at all in any way that the bullying is why this kid wants this operation. And presumably the psych has ensured its not.

I agree with you here. The article makes him sound like the perfect candidate for this operation. Althouse's interpretation sounds strange and I would love to see her defend it.

I only wonder why sex changes/fertility treatments/etc. get funding when people have to wait in line in ambulances to wait in line in hospitals. Sex changes are important, but people are literally dying for lack of care.

"I think you might consider if there's some amount of transphobia or ignorance on your part that makes you increase the role of bullying from how it was cited in the article."

As I say quite clearly, I don't trust the young man's judgment when he is stuck in an environment in which gay males are treated horribly. It's similar to the way some gay kids are suicidal. To say solution isn't physician-assisted suicide is not to exhibit an phobia about death. If a young man thinks he'd be better off as a female, I'd like to know exactly why. I don't trust the government authorities here.

"The NHS has a process and the kid and his shrink just followed it. That's not the NHS' fault."

Absurd! As if "process" makes it okay. The process includes all sorts of judgments about spending money and what's worth doing.

That is the dirty little secret of the liberal's Worldview: talk about the evils of wealth, yet make everything ultimately about wealth and who gets to control it.

THAT is why this conservative left the liberal views of his youth - the hypocrisy and double standard of every liberal I knew and read and watched concern themselves mainly with the attempt to control the lives and resources of other people. Conservatives believe that everyone, given a chance, should have the opportunity to succeed. Liberals believe that if someone has more than someone else - unless they are on the liberal A-list (read Communist Rulers, Al Gore, Hollywood talent, liberal intellectuals) - that THAT is wrong. Conservatives in general are about individual freedom with societal limits that protect and further prosperity and freedom; Liberals - control of the lives of other people for the design and purposes of an elite with societal freedoms that have historically proven to be detrimental to prosperity and freedom.

It plays out everyday in the real; world. So here is the question:

Is the United States of America the Greatest Country in existence today, the beacon to the world of self-government despite it's faults, or not?

If someone's answer involves a grievance list first, then they are as wrong at understanding the question as the person who says "America always right".

That will tell you where your starting point is and whether you are dealing with a reasonable, relatable-to-reality person or not.

You should look at the original article. When you see Ria's picture and watch the video of her you will hopefully take off the "evil" "homosexuality" and "insanity" tags and replace them with "transgendered" or something of that nature.

Helen Mirren has regrets about a rather innocuous tattoo she had while younger. What are the odds that some sixteen year old might have second thoughts about a dickectomy a few years down the line. Radical surgery should be a physician's last option, and this operation qualifies as radical but not as a last option.

Sounds like they are trying to navigate the fine line between various camps of British 'youth'.

According to some camps, the boy should be bullied. According to others, he has the right to be who he wants to be. Since he wants to have sex with men, then clearly the balance is to make him a woman. If he's a woman the first camp of "youths" can't be angry if he wants to have sex with men.

Trying to avoid offending any side generally makes all sides extra angry. But, that's the joy of a good bureaucracy. Everyone might be angry, but the only blame can be attached to a 'process'.

"Sex changes are important, but people are literally dying for lack of care."

Why are so-called "sex changes" important?

Sex, scientifically defined, cannot be changed. Whether you have your external (and internal) gentialia removed makes no difference to your genetically determined sex. That will always remain what it was when you were still in the womb. "Sex change" operations are merely cosmetic surgeries at best and genital mutilation at worst.

Sex (or the lamentable word "gender") is not what women's studies professors say it is.

I have nothing against people who have these operations, so don't bother with the silly "transphobic!" crap. But I do think having these surgeries is a mistake, especially when they're performed on someone who's barely gone through puberty.

I should diagnose from photographs, like Bill Frist looking at videos of Terry Schiavo? How do I know this isn't the case of a boy who was horrified to think he might be gay, did some internet research, discovered a way out and began to enact the symptoms that will get him what he thinks he wants?

"[T[his is my life, and it won't be worth living unless I have that operation.... The doctors have said I need the surgery for my own peace of mind. I hate my body as it is now. Every time I look at my male bits I feel sick because it is not what should be there."

Do you really think surgery is what this boy deserves?

"When he got to secondary school Bradley was attracted to boys and thought he was gay. He also endured cruel taunts like "batty boy". He told us: "I found it hard to deal with the abuse, and I'd lash out. But slowly I began to untangle my thoughts. I realised I was attracted to boys because really I'm a girl.""

But he's not gay, you want to say as a permanent, surgical matter?

I think he deserves to know what life is like in an environment where a gay male is not rejected but is considered normal and perfectly good. He has never had that.

Youths in England have fully transformed into the "Droogs" from "A Clockwork Orange". I know adult English women who now live in America who becone anxious when confronted by groups of young boys. Apparently in England encountering groups of youths is frequently accompanied by harassment or worse. So I'm not surprised that this boy is afraid of going to school. And NO ONE, not teachers, not administrators, not police... will do anything about it. It's not allowed, according to old men in synthetic curled wigs.

Althouse: I think he deserves to know what life is like in an environment where a gay male is not rejected but is considered normal and perfectly good. He has never had that.

And yet you have "evil", "homosexuality", and "insanity" as tags on this post. Ria is of a legal age to make this decision, she has the support of her doctors, she has the support of her mother. Doesn't she deserve to have her own wishes followed?

Oh, and where in the world is she going to go where a gay male is considered "normal and perfectly good"? Only if she lives in certain gay enclaves is she allowed to make decisions about her body?

I think it is evil and verging on insane to be throwing around words like insane and evil, especially when you could very easily be wrong.

"And yet you have "evil", "homosexuality", and "insanity" as tags on this post. Ria is of a legal age to make this decision, she has the support of her doctors, she has the support of her mother. Doesn't she deserve to have her own wishes followed?"

Would you allow a teenager to commit suicide if it was his sincere wish?

Bradley, who will have his name changed to Ria (after his pop idol Rihanna) when he becomes female, first went out in public as a girl when he was 13, with a cousin.

He said: "We painted our nails and she helped me pluck my eyebrows. I bought a brown curly wig and put on hotpants and high heels. I was terrified people would stare and point but no one batted an eyelid."

That is some awesome parenting, letting a 13 year old of whatever gender / orientation run around in hot pants and heels.

Anne, you need to add some more tags "end of western civilization" and "frickin idiot parents".

Do we just get to decide facts for ourselves now? Well then... I've decided that I'm a black person! I demand that everyone treat me as a black person and pay for me to get some sort of melanin treatment to turn me physically into what I've decided I am mentally. I shall check the "African-American" box on all government forms from this day forward. My mother supports me! I shall find a doctor who supports me. I demand affirmative action! I demand you apologize to me for the injustices you inflicted upon my people for centuries! What, you want to administer genetic tests to see whether I really am black?! Genetics lie! Science lies! I know what I feel and that's all that's important! How dare you disagree with me! How dare you question my certainty! Racist! Racist!

"Anne, you need to add some more tags "end of western civilization" and "frickin idiot parents"."

Well, to be fair, this is England we're talking about. I think two World Wars severely depleted the gene pool's stock of rational, good and intelligent people. What remains is a motley collection of hand-wringing women, semi-retarded criminals, fascists, emasculated Tories, pudding-faced bureaucrats, communists, toothless cretins, angry unintegrated Muslims, pussified men in cardigans and other assorted ruiners of that rhinestone set in a silver sea. The few good, rational, brave and intelligent English people are either in the military, living abroad in the US, or have learned to keep quiet lest they get arrested for some though crime or other.

After the cosmetic amputation of this normal healthy gay boy's penis and testicles, the next task for the NHS is to surgically implant surveillance cameras up each citizen's ass.

Althouse: "Evil" and "insanity" are characterizations of the govt that would resolve problems by "treating" victimized individuals with surgery.

Where you come up with the idea that this is something the government does as a matter of course is beyond me. I also did not hear Ria say that she needed this surgery to stop the bullying, which it obviously wont.

If you are so hot to give the minor child what he believes he wants, would you give him a lethal injection if he was suicidal?

Definitely, just like all the supporters of gay marriage want men to be able to marry their own daughters and women to be able to marry horses. Because every issue is a slippery slope with no gray areas.

Leaving the bullying aside, one of the main issues that emerges is the use of taxpayer money:

"The cost cannot be justified while other patients are denied life-saving cancer treatment on the NHS, the TaxPayers' Alliance said."

The teenager in question, later in the article, barely acknowledges this - he just says that people will say horrible things about how the money could've gone towards saving a life... but this is my life, and I want it to change, so... that's what counts the most.

I do agree that the NHS has much bigger problems that it should be spending its time and energy on than this.

But what really bothers me is the age of the guy (sorry, in my world, he is still a guy until the sex reassignment surgery is complete). Now, my understanding is that 16 in the UK is like 18 here in a lot of ways. But regardless, my biggest problem is his age.

Over the last couple of years, I have known a number of kids his age, and they just don't have any conception at that age of the world around them. More importantly here, they are in the midst of becoming sexual adults. And for the boys, I think it is worse than for the girls. They are newly cranked up on testosterone, and are having all sorts of problems with their sexual identity.

The guy may be gay. Many of the gay guys here probably knew at that age that their sexual orientation differed from most of the rest of us. But the difference here is that this is pretty permanent surgery. This boy, at 16, would be giving up having his own kids for the rest of his lifetime. Even if he changed his mind later, and decided to be a guy again, it would be too late. I would be a lot happier if he waited until 21 or so to make this sort of life long decision.

I think what is saddest here is that this whole thing is socialized medicine's response to a failure in socialized education. If he is bullied in school, then cut off his male sexual reproductive organs so that he can be a female (never mind that female bullying tends to be worse than male bullying - bet he didn't take that into account).

"If he is bullied in school, then cut off his male sexual reproductive organs so that he can be a female"

It's worse than that: cut off his male genitalia so he can be a eunuch who can pretend he's a female.

But he won't be a female. He won't be able, as many females are able, to bear children. He won't, as an otherwise healthy, genetically male person, be able to father children even by artificial insemination. He's going to be doomed to a life of childlessness and lifetime of taking medications to maintain his perhaps temporary delusion.

Thank God I didn't make any such permanent decisions when I was 16. I would surely have made the wrong ones if given the opportunity.

Althouse: The schools are run by the government. If there is harassment in school it is a problem that the government has failed to solve.

No, you are saying that the British government gives sex reassignment surgery to gay (not transgender) children (16 year olds) instead of solving the bullying problem (which no one says the surgery would solve).

This is actually the policy of Iran, by the way.

We have someone here who lives as a female, insists she is called a female name, has been adamant about this for years, and is disgusted with her male parts. She has the backing of her mother, who loves her, and her doctors, who I'm sure are well trained in weeding out people who aren't psychologically ready for this procedure.

And on Althouse we get a link to an article which doesn't include pictures or video of the person; that's been depersonalized; and has tags like "evil", "homosexuality", and "insane" surrounding it. And you keep on calling her a "he".

There's a lot of concern about her possibly making a decision she will regret later, but not enough concern to show her as a human being or admit that this might be a good thing.

As I say quite clearly, I don't trust the young man's judgment when he is stuck in an environment in which gay males are treated horribly. It's similar to the way some gay kids are suicidal.

I'm about to turn off the internets and watch the Saints knock Brett Favre on his ass, but I want to weigh in quickly to agree with Althouse here.

I knew of my attraction to other girls, to women, when I was no more than 4. In a religious family, in the 1960s, and early 70s, one way I tried to process that was to assume it would be fine if I could just go to bed one night and wake up a boy. I prayed for that for a couple of years, from around age 10-12, until I started seeing other gay people - on TV, on the softball field, on the military bases where my dad worked, in all sorts of pop culture places - and realized, hey, I just have to hold out for awhile and I'll be fine.

I'm not trans, not remotely, but in an environment where there was no way for me to understand that I'd be just fine, it made sense that since it's okay for boys to like girls, I needed to be a boy. I thank God now that there was no option for me to start gender reassignment treatment, and I worry about it being available now. I do believe there are indeed kids who do know their own heart and will go through it, and they ought to be protected and allowed to figure themselves out. But the cultural realities of homophobia, and internalized homophobia and misogyny, make me dubious of going right from struggling with one's identity to reassignment surgery.

Just my thoughts - sorry I have to skip any debate. I'm in serious Black and Gold mode now.

The problem is that you keep calling a genetic male a "she". Some of us think scientific realities are a better indication of truth than feelings.

You can't force other people to accept things they know rationally to be untrue and to accept false meanings of words, just as other people can't force you to cease making factual and linguistic errors. Your increasingly hysterical shaming techniques can't force other people to call blue, orange and up, down.

"But the cultural realities of homophobia, and internalized homophobia and misogyny, make me dubious of going right from struggling with one's identity to reassignment surgery."

Exactly the point I've been arguing. I want this boy to learn to love and accept his God-given gayness, and I don't think he's being given the chance to do that. And soon that chance will be forever revoked.

I think his mother and his "psychologists" should be criminally culpable for what they've pushed him into.

You might want to think about Roper v. Simmons, the Supreme Court case that said that persons under 18 years of age at the time of committing a crime can't be given the death penalty and the current scientific evidence about the maturing of the human brain. Check out this website and some of the links at the bottom under "resources," such as "New research shows stark differences in teen brains" ("some scientists would put off the age of legal majority to 22 or 23... there will likely be considerable debate over how to tell when a person's brain physically looks like an adult's as imaging research continues and efforts to set standards and norms develop.").

"The story of teen brain development lies in a process called myelinization, in which a layer of fat coats wire-like fibers connecting regions of the brain, back-to-front, side-to-side, and everywhere in between. Over time, this makes the operation of the brain more precise and efficient, affecting not just thinking and problem-solving, but also coordination and mastery of skills ranging from throwing a baseball to playing the trombone."

Althouse: "some scientists would put off the age of legal majority to 22 or 23"

I'm waiting to see the post you do on 20 year olds joining the military (where they might die), with "evil" and "insanity" tags.

None of this explains why you have a "homosexuality" tag and not a "transgendered" tag on this post or your need to call someone who wants to be called a "she" a "he".

Someone I respect once talked about a world where gay men are not rejected but considered normal and perfectly good. I would include transgendered people.

I think that some consider the transgendered to be insane and that giving them the surgery they request to be evil. Maybe they aren't conscious of their own motivations, but they spill out sometimes. Of course these people have seemingly reasonable justifications for what they say, or so it would seems until someone else examines them.

Many, possibly most, of the things I thought at sixteen about myself and how I wanted to live turned out to be false. I wonder if that's true of other people.

And while I feel for people with transgendered feelings, I think it is absolutely barbaric that the treatment for such feelings is to mutilate the body. I'm not ignorant of the subject. I've done the research. I've read plenty of stories of transgendered people, read about the procedures, the upkeep. I think it's wrong, and I think people will look back on these times and not think well of us for prescribing these treatments. Especially to young people. (Some people are beginning treatments on prepubescents to stave off puberty.)

I think a much more humane course would be to teach people to accept themselves for who they are. You can be an extremely feminine man or an extremely masculine woman, and that's okay. You don't need some doctor telling you that maybe you should be cutting up your bits to give the appearance of the other sex. But that's just my opinion.

I would also point out that there are all manner of disorders related to rejection of the body. I know of no other where the "treatment" is surgery. Would you tell an anorexic to lose to seventy pounds? Would you tell a man with body dysmorphic disorder that he should pump himself full of the most extreme steroids he can find?

"I know of no other where the "treatment" is surgery. Would you tell an anorexic to lose to seventy pounds? Would you tell a man with body dysmorphic disorder that he should pump himself full of the most extreme steroids he can find?"

it is wrong to condemn the nhs for one decision. granted there is more than one wrong decision the nhs has made; however, there are many wrong decisions made every day here under u.s. healthcare, as we all know...the nhs (which is not compulsary - you can opt to go private and at far less cost than here) is like an hmo. you see a gp (of your choice! and you have the option of changing your gp) and if necessary he/she refers you to a specialist and/or hospital, and in this case a psychologist, since therapy and psychiatry are also covered under the nhs. the 18month wait for the operation in this case leaves much time for reconsideration by all parties. the nhs has its problems, but in the time i spent living in the uk, i found that it was a comfort to know i would receive medical care when needed and not have to worry if i could afford to pay for it. i also knew the doctors could be trusted since they weren't doing things just for the extra money. it is CIVILIZED medicine, and anyone who has lived in a foreign country knows just how unfair our medical delivery system is, and how hard to change it when there is such misinformation and such megabucks, vested interests, lack of rational discourse. one small example: nothing in house or senate bill addresses the fact that (although hearing aids are also covered under the nhs) here a decent hearing aid can cost as much as $2000 a pop and is covered by no insurance i know of except (in part) by medicaid. all medications in the uk are also nhs covered for those over 60.

the problem isn't the "red herring" of "socialized" medicine, but greed, and lack of compassion.

My experience in the transgendering field may be of interest here. When I was sixteen, I had, in addition to an irritable penis, a complexion that closely resembled a pepperoni pizza fresh from the oven. That and a disposable income of about five dollars a week soon brought me to the realization that life sucked and girls didn't. You don't need to be gay or black or bullied to have a miserable adolesence. My despair was very real....Fortunately my family and I lived in a forward looking, northeastern state with many humane social programs. There was at that time an experimental program, since dropped, designed to bring succor to wretched souls such as mine. I had a vulva transplanted to the palm of my right hand. The vulva came from an organ donor, a young lady who had recently perished from an overdose of emitics.....The operation was a successful, but perhaps too successful. The acne passed away but not the handy vulva. I sometimes spend twenty hours a day in bed honoring the memory of that dead bulimic. If if I had it to do over, I would perhaps make a different decision. One should not make irrevocable decisions at the age of sixteen.

One of the worst, and least noticed, elements of this article is that that kid got kicked out of school because he FOUGHT BACK against the taunting and bullying. How F'd up is it that?

It's because the bullies are clever. They know how to commit their violence undetected. Whereas, the victim filled with frustration and rage does not properly plan their revenge and ends up being discovered.

If you have studied mental disorders you know that many of them don't have cures, especially personality disorders. Often the treatment is giving the patient medication to keep them from acting out. Sometimes the medications have strong side-effects which leave the patient feeling like crap their entire lives.

Anorexics will kill themselves if you let them make their bodies the way they want them to be (plus they'll never be happy with them). Having your sex organs removed is not lethal. And with sperm and egg banks doesn't necessarily mean never having your own children. Not letting the person have the operation may result in self-mutilation, suicide, or feeling like crap.

These people are different from effeminate men or butch women. Look at Ria and listen to her on video.

Also, transgendered people get treated like crap by a lot of people, even in the gay community.

Jason, every time I see a Victoria's Secret Catalogue, I see myself as the sort of woman who can wear one of their daring cleavage-celebrating v-neck tops. Then I go shopping and am frustratedly reminded that some twist of genetics means that, at 30 years old, I'm still pretty much limited to training bras.

Were I British, should the NHS give me tasteful implants? Why or why not? Should they have given them to me when I was 16?

Lyssa (who IS lovely, as long as you're not into big tits...or medium tits, or really even sort of small tits)

Jason - yes, I agree: why not a transgender tag? And why the other tags? Is "evil" for the bullying? Or for the UK NHS decision? I don't understand.

I've met people who've regretted transitioning surgically. Sometimes I wonder if this is the new frontier; it's just more exciting than plain old vanilla gay. But I've met more people who've transitioned and are happy and at peace with themselves. My worries remain about what age is appropriate to start a physical transition, and about how one sorts out cultural forces.

Re-reading this story, I don't see that the surgery is being paid for because this child is being harassed, but because the child has been identifying as a girl since a young age. My concerns remain about how that might come about - the reasoning of "I like boys because I'm really a girl" isn't all that persuasive to me, but it's not insane.

We spoke for 2 1/2 hours on why cross gender identity was a normal inherited variation of humans. We showed how Transgender Brains think, smell, and hear like the opposite sex. We presented internationally accepted guidelines for hormonal treatment of transsexuals to be published Summer 2009.

Here are my slides and with my participants' permission I shall send you theirs. We are now in print in the APA Syllabus and soon in the APA Journal this summer. I am checking if we were recorded.

My greatest personal compliment came from Frank Kruijver, from Holland, whose research of the human brain in TSs started it all. He thought we have taken his work very far in our understanding of the human brain. Hope you can do something with this.

Sid Ecker, M.D.

That's from Professor of Urology Dr Sidney Ecker, after giving a presentation to the American Psychiatric Association's annual meeting, in seminar S10:

Note that these weren't trick cyclists. They were people knowledgeable in anatomy, physiology, endocrinology, urology, and genetics.

And their conclusions weren't based of some political ideology, trendy leftist philosophy, "gender studies", religious belief, or subtle effects from questionable "soft science" of dubious merit.

They were based on autopsy results, and fMRI scans. Repeatable experiments. Hard Science.

The sound byte? Transsexuality = Female brain in male body, or the reverse.

I grossly over-simplify: I should be drummed out of the regiment for it. It's as bad as saying "The Earth is Spherical" rather than talking about spheroidal shapes, semi-major and semi-minor axes, masscons causing relativistic space-time distortion, not forgetting irregularities such as mountains and ocean depths etc.

But it captures the essence, and is a heck of a lot better than a flat Earth model. And unless you want me to talk about the Left Frontal Gyrus, lymbic nucleus, and BSTc layer of the hypothalamus, close enough.

Transsexuality is an Intersex condition, like many others. "Intersex" meaning "with a body that isn't 100% stereotypically male not 100% stereotypically female."

Now why a feminised brain (in certain areas, not necessarily others) always and without exception is associated with a female gender identity, we don't know. We have a good theory, but testing it is tricky. All we do know is that we've never found an exception. Feminised Brain => Female Gender Identity, no matter what the rest of the body looks like.

We can reliably induce transsexuality in experimental animals by appropriate hormonal manipulation during gestation.

Obviously experimentation like this on Humans is ethically unsound, to put it mildly. So we have to rely on studying that minority of people with unusual Intersex conditions. "Nature's Experiments".

This comment is already over-long, but I can summarise the situation here as follows:

This child is not a "healthy boy". She is a girl who's suffering from a truly horrible congenital anomaly, she has a body that looks mainly male.

If you can understand that, you understand everything. If you don't understand that, you will misinterpret and misconstrue everything. As some of the comments attest to.

"We can reliably induce transsexuality in experimental animals by appropriate hormonal manipulation during gestation....This child is not a "healthy boy". She is a girl who's suffering from a truly horrible congenital anomaly, she has a body that looks mainly male".

You don't actually teach that claptrap, do you?

If it is hormonal, it's not a "congenital anomaly", which refers to a genetic disorder.

You are screwed up on basic biology, by quite a lot. XY is not a girl, it's that simple. Shared brain patterns between lesbians and males don't make them males, unless you're changing the scientific definitions of "male" and "female".

Which is in fact what you are doing.It's bullshit.More likely it's a hormonal problem, which reshapes the brain, perhaps in utero or later or both.

I have no problem with the idea of gender reassignment in theory, but 16 seems a little young for surgical intervention.

As a general rule, I'd say the person needs to have socially lived as the other gender for at least 2 or 3 years (arbitrary number) as an adult before going under the knife and there needs to be counselling, including some of the devil's advocate kind.

In this case, I do think the confusion about gay/transgender is an artifact of bad and/or inaccurate reporting than saying about this case. That is, I don't think the writer knows the difference between gay and transgendered.

"This child is not a "healthy boy". She is a girl who's suffering from a truly horrible congenital anomaly, she has a body that looks mainly male."

I would expect that the hormonal, genetic and other factors that produce a mostly male body would do likewise with the brain in nearly all cases. I would need some explanation of how the brain develops in direct opposition to the factors affecting the rest of the body's development.

I suppose there may be some mechanism that could explain it, but it seem much more likely the divergence is learned, or at least psychological rather than physical.

Jason, I think you make an excellent point about many psychological disturbances being incurable and that these treatments, perhaps, represent a cure for some. I'm not sure that I agree with the approach, but I see your point.

However, I still think that sixteen is far, far too young for that kind of decision. Sixteen year olds are very foolish; not because there's something wrong with them but because that's part of being sixteen. No life experience. When I think back on being sixteen, I am very amused at the memories of so many adults telling me how mature I was. Absurd! A sixteen year old, no matter how impressive and seemingly soberly rational, does not have enough biological, as Althouse pointed out, or experiential maturity to make these decisions. A parent who would just go along with something like this at this age is, I think, abdicating her responsibility to her child.

Adults must not forget that they are the adults, and teenagers are not among their ranks.

Freeman Hunt: However, I still think that sixteen is far, far too young for that kind of decision. Sixteen year olds are very foolish; not because there's something wrong with them but because that's part of being sixteen. No life experience. When I think back on being sixteen, I am very amused at the memories of so many adults telling me how mature I was. Absurd! A sixteen year old, no matter how impressive and seemingly soberly rational, does not have enough biological, as Althouse pointed out, or experiential maturity to make these decisions. A parent who would just go along with something like this at this age is, I think, abdicating her responsibility to her child.

We have a 16 year old who thinks this good for themselves. We have doctors who think this good for their patient. And we have a mother who thinks this good for her child.

You, Althouse, and I are strangers who read the story on the internet.

I would never think of intervening in this case and I find the "evil" and "insanity" tags to be totally outrageous. Freedom is about letting people mess up their lives, I'm not endorsing taking that away from these people, it may be the only thing they have.

I have faith that everyone involved is acting in what they consider to be the best interest of Ria. If you insist on infantilizing the mother and the doctors as you do the 16 year old, that is your right. I refuse to see the world that way and think that point of view is what inevitably leads to well meaning dictatorships.

Oh, and the "homosexuality" tag? That's Althouse giving her diagnosis based on a written description. I used pictures, video, the opinion of the person involved, their mother, and their doctors to make a determination.

Althouse: I should diagnose from photographs, like Bill Frist looking at videos of Terry Schiavo?

Althouse is worse than Bill Frist; at least he had video!

Freeman Hunt, I would not try to make Althouse sound more reasonable. I started out in this thread just saying her opinion seemed kind of strange and asking for more information and look where it got me.

If anyone ever wanted proof that conservatives are opposed to freedom, please use this entire post as proof thereof.

It's also worth noting that conservatives are vehemently opposed to anti-bullying legislation (notably the Wall Street Journal and Instapundit). The main reason they are opposed is that it would make it illegal for kids to beat the crap out of gays in school.

Conservatives LOVE when bullies beat the crap out of gays in schools, as they think it will help make the gay kids straight.

I kid you not. This is the main reason why conservatives are opposed to the election of a Mark Kirk (a Republican) to the Senate in Illinois.

pogo wrote:More likely it's a hormonal problem, which reshapes the brain, perhaps in utero or later or both.

In utero, certainly. Hormone treatment afterwards also has an effect of course, but not in the areas we're talking about.

pogo wrote:Shared brain patterns between lesbians and males don't make them males, unless you're changing the scientific definitions of "male" and "female".Oh I agree completely. The shared patterns there are in another area of the brain entirely. An area that controls sexual orientation, not sex identity.

You do know that lesbian trans women and gay trans men exist, don't you? That sex identity is a separate concept from sexual orientation?

bagoh20 wrote:I would expect that the hormonal, genetic and other factors that produce a mostly male body would do likewise with the brain in nearly all cases.Correct. Only 1 in 3000 people are transsexual.Though about 1 in 10 people who are transsexual also have other intersex conditions too to some degree. "Mostly" male is right.

And of course, it happens to boys too. We're not sure whether it's one in two who are male, or one in four : the ability to "blend in" as just another butch lesbian, a rather more societally acceptable situation than a trans man, confounds the issue.

I would need some explanation of how the brain develops in direct opposition to the factors affecting the rest of the body's development.So would I! In fact, experiments on animals during foetal development illustrate the process, but I can't say we fully understand all the machanics involved.

But we can observe the effects. Every cattle farmer is familiar with "Freemartins". Studies on differently-sexed twins (who thus have some hormonal anomalies during development) are also useful.

See for example: Prenatal exposure to testosterone and functional cerebral lateralization: a study in same-sex and opposite-sex twin girls. by Cohen-Bendehan et al

I suppose there may be some mechanism that could explain it, but it seem much more likely the divergence is learned, or at least psychological rather than physical.A reasonable hypothesis. Testable too, if so, one would expect there to be a psychological cure for it in a significant number of cases.

Unfortunately, there's not a single study in the last SIXTY YEARS of trying to cure this condition that has ever found a single, verified, long-term success. It's not as if they haven't tried (and continue to do so). It's not that the cure rate is low, it's non-existent, despite heroic measures.

The rate of cure from patient psychotherapy is in fact exactly comparable to that in treating amputees or the blind by the same techniques.

There's also a problem with the lack of any plausible psychological causative mechanism.

Solid evidence for the importance of postnatal social factors is lacking. In the human brain, structural differences have been described that seem to be related to gender identity and sexual orientation.

That's why there was a presentation to the APA. I'll give the abstract of one of the presentations in the next comment (character limitations).

Oh yes - I far prefer the term "sex identity" over "gender identity" for technical reasons I'd rather not go into. It means the internal knowledge that one is either male or female though, either way.

Abstract: Gender Identity is that innate sense of who you are in this world with reference to your sexuality and behavior, not necessarily corresponding to your genitalia and reproductive organs. Transgenders are atypical and “think” as the opposite gender. Certain areas of the brain have been shown to be sexually dimorphic. They are different in structure and numbers of neurons in males versus females. Protein Receptors for the sex hormones in different areas of the brain (limbic and anterior hypothalamic) must be present in sufficient numbers to receive those powerful hormones. There are androgen receptors (AR), Estrogen Receptors (ER), and Progesterone receptors (PRs). ARs or ERs are predominant at different times in different parts of the human brain. Hormone receptor genes have been identified in humans, which are responsible for sexually dimorphic brain differentiation in the hypothalamus. The groundwork in brain gender identity is gene-directed and takes place by forming male and female hormone receptors in the brain before the gonads and hormones can influence them. Multiple genes acting in concert determine our sexual identity. The human brain continues to make neurons and synaptic neuronal connections throughout life. This contributes to Gender Role Behaviors making individuals in the continuum of gender identity. Gender behaviors must be differentiated from gender identity (Hines). Gender Identity cannot be predicted from anatomy (Reiner). Brain gender identity is determined very early in fetal development, but gender expression, expressed as behaviors requires hormonal, environmental, social and cultural interactions, which evolve with time. One cannot deny the profound effects of Testosterone, Estradiol and other steroids on genital differentiation in-utero or their effects on behavior from birth or the physical and mental cross gender changes caused by exogenous hormones, but gender identity is determined before and persists in spite of these effects.